size of uterus

I've been reading several posts by sisters who have or had enlarged uterus' and large fibroids and still had LAVH or SAH surgery done. The drs. I've seen have told me that I am too big to have anything but a TAH. How large have you sisters been? Is there anything I should be asking about? I was told last month that my uterus is about the size of a man's head (it contains a very large fibroid). I am just curious as I am not thrilled with having the TAH if it is possible to do something else.

Am one who has opted for TAH. Have large uterus (3-4 month pregnancy size after 4 kids). I know opening me all the way up through my abdominal wall is more painful, and a longer recovery, and has a higher risk of adhesions - BUT, I think of it this way: I WANT the surgeon to know and see everything well.

I am a seamstress. I cannot imagine stitching and sewing by camera! To do laproscopic surgery it is by camera, and not a direct visual, so I really do feel better if he opens me up and has a clear field of vision.

I had carpal tunnel done, and had the open or closed option and I chose open, so the surgeon had a better field of vision. I just don't want my belly blown up and everyone running around in the dark, so to speak. I ask both surgeons which one THEY felt more comfortable doing, and both said: "To be honest, it is more thorough with opening you up, and I DO get a better view of it all". SO - I said, open me up, if you have a better field to work in, do it. I will recover a bit longer, but at least I will feel they have seen everything and have enough room to work without strain and stress with some little camera job.

I've been in the medical field quite some time, and have watched them work with laproscopes, and honestly, I think it is very tedious and stressful, so I feel more comfortable letting them do the TAH, rather than either the TVH (if it were possible) or a lapro procedure.

I am having a SAH in June for fibroids with a uterus the six of a 24 week pregnancy. My DR. is doing a vertical incision for uterine removal but will be leaving in my cervix and overies. My understanding from research on the internet is that leaving your cervix provides more support of the vaginal walls and fewer problems later in life. What do you other sisters hear of this?

I asked my DR about leaving the cervix to prevent vaginal prolaspe. She said she's aware that some surgeons aren't as careful to make sure the top of the cuff isn't as secure as it should be. She reassured me that this is one of her pet peeves, ie: she's very careful to make sure the top of my vagina is secured so it won't prolapse later.

The following is from a site called The Pelvic Floor. It is by a DR and shows pictures from actual surgeries, it is very graphic; I don’t want to offend anyone so I don’t include the link.

	Quote:
"It has to be made clear that the smallest or most inconspicuous incision, is NOT always the best. Unfortunately I can't explain here why that is, but trust me, its true. Or better yet, don't trust me at all; ask your own doctor...

The only difference between a TAH and SAH is that the TAH is a total removal of the uterus and SAH is not removing the whole uterus, the neck (also called the cervix) is left. They are both done with an abdominal incision, either vertical or horizontal.

The lap assisted vag hyst (LAVH) is done vaginally with (usually) three small incisions to insert the instruments. The uterus has to fit through the vagina. Some DR's may cut the uterus up to remove it if it's too large. Cutting it up may not be possible without also cutting up the fibroid. There may be reasons why they don't cut the firbroid.

If you are uncomfortable with your DR and his/her choice of surgical method it would be advisable to get one, two, three, or however many other medical opinions is necessary until you are sure.

Susan

If you have concerns it never hurts to get another opinion. My surgery will be done abdominally because of size and that's okay by me. I read your post and I just can't get my mind around having a man's head removed vaginally. I think for me the visual aspect of the incision will help me to remember I need to behave myself and heal. I really enjoyed Flowersam's point of view so hopefully it helped you too. Good luck with your surgery and prayers for a speedy recovery. Henri

My doctor did not want to do a vag hyst because my uterus was 4 month pregnancy size, with large fibroids on the outside. I also liked the idea that the TAH gave him a good view of my insides.

The size of a man's head? Well that could be like having a 10 lb. baby? Even a great GYN surgeon probably wouldn't want to do that?

I was told my uterus was 12-14 size--and I've had 3 babies--a 7lb. and two 8 lbs. I was plenty sore afterward. I had the LAVH for adeno and fibroids and the doctor was able to confirm no visible endometriosis and normal ovaries. I am thrilled with the results.

BUT if my doctor said my uterus was the size of man's head--I would say forget it--and have the TAH. My doctor even said the worst thing is to get the thing out 3/4 of the way and THEN find out you have to to the TAH. I guess then you'd really be sore all over. If he's giving you a realistic estimate...

Good luck!
Mary W

I also had an abdominal hyst and was not given an option. I got opinions from 3 doctors before I felt comfortable with my decision. I was told I had an enlarged uterus, but can't remember now how large (they gave me measurements only).

I was glad to have a TAH for the same reason as boulet, so he could get a good look inside.

As it turned out, he found a small amount of endo on my ovaries/tubes that I didn't even know I had! He was able to remove the endo and leave the ovaries in.

I am very thankful because if he had not discovered it, it would have caused problems (or another surgery) down the road!

Best of luck,

Thank you everybody. I think that I was having a very emotional time last night and as I read the posts about TVH, I started thinking that I might be able to do it. I have put off surgery for three years. The doctor who told me I had fibroids left. The next doctor I went to wanted to do a hyst. and take my ovaries, no other options. To make a long story short, I just wasn't sold on that. So, 2 years later, I am going to another doctor who says he will leave my ovaries if possible. That's okay by me. I like his approach to the matter. Anyway, thanks again for the info and support. By the way, I had to laugh when he said I had a man's head in my belly. I wanted to know how in the world he got in there without me knowing and I'd like to know if he is good looking or not!!!! (Size of uterus: 28 weeks)